OBJECTIVES

This study aimed to determine the motivating and hindering factors affecting the Infant and Young Child Feeding (IYCF) practices of Muslim mothers in select municipalities of Maguindanao.

A pretested questionnaire was administered through face-to-face interviews conducted among 320 randomly selected Muslim mothers with a child aged 6-23 months.

Results revealed that prelacteal feeding was practiced by 16.6% of the Muslim mothers, giving mostly plain water. Solid/semi-solid foods were introduced at a mean age of 6.1 ± 1.4 months, with home-cooked lugao (porridge) (55.0%) and commercial baby food (31.3%) as the top foods introduced. The majority of Muslim mothers (82.5%) fed processed foods as complementary food to their children, including instant noodles (85.2%) and canned goods (51.5%). These processed foods were mostly obtained from sari-sari stores, with TV as the top source of information. More than 80% of the Muslim mothers cited food availability, economic reasons, and convenience in food preparation as the top three motivating factors in the practice of complementary feeding (CF). In addition, almost all the Muslim mothers (~97%) mentioned seeing their children grow healthy as the top reason for improving their food preparation practices, followed by positive feedback from their families. Meanwhile, household duties, low milk output, and a new pregnancy make it difficult to continue breastfeeding, while high complementary food costs, a limited budget, and a lack of food make it difficult to provide complementary food. The preparation of food for infants and young children is hindered by an increased workload and a lack of understanding.

The results revealed suboptimal practices in prelacteal feeding and the reliance on processed foods among Muslim mothers, with economic factors, availability, and convenience as motivating factors in complementary feeding practices. Challenges such as household duties, low milk output, and financial constraints hinder breastfeeding and nutritious food provision for infants and young children. The study reinforced the necessity for holistic strategies in IYCF promotion among Muslim mothers.

BACKGROUND/OBJECTIVE

Although nutritional assessment tools have been available internationally, local data for their use in foreseeing adverse outcomes among admitted patients are currently unavailable. The primary objective of this study was to determine the association of nutritional status using Short Nutritional Assessment Questionnaire (SNAQ) and malnutrition risk using the MST (Malnutrition Screening Tool) with ICU admission and in-hospital mortality.

This was a prospective-cohort study which included 122 purposively-selected adult participants who were non-intubated, admitted for medical and surgical managements, stayed for at least 24 hours, had no COVID-19 infection, and were not admitted in any critical care unit. The SNAQ and MST questionnaires, which are validated tools and consists of  two to three easy-to-answer questions, were used among the participants and their scores were tallied in order to get their nutritional status and malnutrition risk. Primary endpoints measured were length of hospital stay, incidence of mortality, and ICU admission rate. Comorbidities were taken into account using the Charlson Comorbidity Index.

Categorizing the SNAQ scores showed 33.61% were severely malnourished which was similar when using the MST classification, wherein 34.43% were at risk of malnutrition. None of the participants were admitted to the intensive care unit (ICU). Malnutrition risk and nutritional status was not significantly associated with 30-day in-hospital mortality (p >0.05). On the other hand, results of the Cox proportional hazards showed that SNAQ and MST significantly predicted the hazard of 30-day in-hospital mortality, increasing the hazard of mortality by 2.58 times and 3.67 times, respectively, for every 1-unit increase in SNAQ and MST scores. Similarly, nutritional status using the SNAQ classification indicated the severely malnourished category significantly predicted the hazard of mortality, increasing it by 9.22 times for those who are severely malnourished. Also, malnutrition risk using the MST classification indicated that those who were at risk of malnutrition were 9.80 times at greater hazard of mortality than those who were not at risk of malnutrition.

The MST and SNAQ classification are screening tools for nutritional status (SNAQ) and malnutrition risk (MST) that can be administered at the onset of the patient’s hospital course and have been demonstrated in this study to predict 30-day in-hospital mortality. It is important to note that none of the patients included in this study required intensive care unit admission.

BACKGROUND

There is an increasing population of elderly patients with diabetes. Malnutrition has been associated to higher morbidity and mortality among these patients. Currently, there are limited data on malnutrition and its risk factors among elderly patients with diabetes in the Philippines.

This study determined the prevalence, clinical profile and risk factors associated with malnutrition and identify the association of malnutrition with glycemic status and insulin resistance among elderly patients with diabetes.

This is a cross-sectional study involving 117 elderly patients with diabetes seen at a tertiary hospital in Manila, Philippines. Demographic, anthropometric, and clinical data were collected. Mini-Nutritional Assessment-Short form (MNA-SF), Simple FRAIL questionnaire and Mini-cog assessment were administered. Patients were categorized into normal, at risk for malnutrition, and malnourished using the MNA-SF. Comparative and logistic regression analyses were performed to identify the clinical profile and possible risk factors.

The prevalence of malnutrition was 1.71% with 29.06% at risk for malnutrition. There was no significant difference in demographic, anthropometric and biochemical parameters between the different nutrition statuses. High BMI, central obesity, and increased insulin resistance were observed across all nutrition status. Frail patients had almost five times increased likelihood (OR=4.94, p=0.043) of developing malnutrition. Good glycemic control had two-fold decreased likelihood (OR=0.44, p=0.050) of malnutrition. Insulin resistance was not associated with malnutrition.

Malnutrition is prevalent among elderly patients with diabetes. Frailty and poor glycemic control increased the risk of malnutrition. Therefore, malnutrition screening should be routinely performed among these patients. Diabetes management among elderly patients should include maintaining good glycemic control and preventing frailty and its complications.

Background: Severe acute malnutrition (SAM) in children under five years remains a major global health concern. It carries a burden to the overall health of a child, contributes to mortality, and adds financial strain to the family and the hospital. The Philippine Integrated Management of Acute Malnutrition was established to address acute malnutrition in Filipino children. Objective: This study aimed to determine the factors affecting survival of patients admitted at Bicol Regional Training and Teaching Hospital (BRTTH) In-patient Therapeutic Care (ITC). Methods: This is a retrospective cohort study design utilizing survival analysis. Accrual period was from January 1, 2018 to December 31, 2018. Follow-up ended on March 31, 2019. There were 154 admissions and excluded 17 missing charts. Survival analysis was done utilizing STATA 14. Results: The prevalence of SAM requiring ITC admission was 3.0 percent. Majority belonged to 6-59 months of age (63%), with equal predilection for both sexes (1:1) and 71% came from the home province, Albay. Most of patients’ caretakers had middle educational attainment. Sixty-eight percent (68%) were new patients, 16% readmitted, 15% transferred from the Out-patient Therapeutic Care (OTC) and <1% relapsed. The top three most common complications and co-morbidities include: pneumonia, low electrolytes, and fever. Sixty-three percent (63%) of patients at the ITC had a desirable treatment outcome, of which, 8% were cured and 55% transferred to OTC. Undesirable outcomes accounted for 37% of the cases which included non-cured, defaulter, and died at 12%, 8%, and 17%, respectively. The risk of dying was higher in SAM patients with parents having middle and low educational attainment as compared to those with high educational attainment (2-5 folds to 100-200 folds). SAM patients presenting with hypovolemic shock were likely to die by 1.5-19 times (1.5-19x) as compared to those without. SAM patients with malignancy were more likely to die 4-44 folds as compared to patients without malignancy. Conclusion and Recommendations Educational attainment of parents, malignancy, and hypovolemic shock were significant predictors of mortality. We recommend prompt intervention by educating families, strengthen policies targeting socio-economic determinants, capacitate medical staff, refine current clinical practice guidelines and treatment pathways to reduce the number of children who die from severe acute malnutrition.
Severe Acute Malnutrition ; Survival Analysis

Objectives: This study aimed to determine the motivating and hindering factors affecting the Infant and Young Child Feeding (IYCF) practices of Muslim mothers in select municipalities of Maguindanao. Methods: A pretested questionnaire was administered through face-to-face interviews conducted among 320 randomly selected Muslim mothers with a child aged 6-23 months. Results : Results revealed that prelacteal feeding was practiced by 16.6% of the Muslim mothers, giving mostly plain water. Solid/semi-solid foods were introduced at a mean age of 6.1 ± 1.4 months, with home-cooked lugao (porridge) (55.0%) and commercial baby food (31.3%) as the top foods introduced. The majority of Muslim mothers (82.5%) fed processed foods as complementary food to their children, including instant noodles (85.2%) and canned goods (51.5%). Conclusion The results revealed suboptimal practices in prelacteal feeding and the reliance on processed foods among Muslim mothers, with economic factors, availability, and convenience as motivating factors in complementary feeding practices. Challenges such as household duties, low milk output, and financial constraints hinder breastfeeding and nutritious food provision for infants and young children. The study reinforced the necessity for holistic strategies in IYCF promotion among Muslim mothers.
breast feeding, Islam, malnutrition

Background and Objectives: Malnutrition is a serious public health problem in developing countries, including Indonesia. Based on RISKESDAS 2018, the prevalence of stunting aged 13-15 years in Takalar Regency is 24.83%. This study aimed to assess the prevalence of stunting and the determinants of stunting in adolescent girls aged 13-15 years in the South Galesong District, Takalar Regency. Methods: This is a cross-sectional study using purposive sampling method that included 247 adolescent girls in selected junior high schools. Data collection used questionnaires and anthropometric measurements. An anthropometric measurement was converted to the indices of nutritional status using World Health Organization Anthro Plus software. Results: The prevalence of stunting was 25.1%. Bivariate analysis showed determinant factors related significantly to stunting were energy intake (p<0.001), protein intake (p<0.001), iron intake (p<0.005), and zinc intake (p<0.001). Multivariate analysis showed determinant factors related significantly to stunting were zinc intake (p<0.001, OR=7.993), protein intake (p<0.05, OR=2.248), and knowledge level (p<0.05, OR=2.032). Conclusion The occurrence of stunting is related to the quality and quantity of food and the level of adolescent knowledge about balanced nutrition. It is necessary to hold educational programs and interventions on improving nutrition initiated by stakeholders and the department of health, in this case, the health center is needed to reduce stunting rates, especially among adolescents.
Malnutrition ; Growth Disorders ; Adolescent

In the Philippines, the escalating double burden of malnutrition necessitates an exploration of healthcare professionals' nutrition proficiency. This study aims to evaluate the nutrition knowledge, attitudes, and practices of resident physicians, providing insights into areas that may require enhancement in their nutrition-related competencies. This study aims to assess Resident Physician's knowledge, attitude, and practices regarding nutrition. Employing a descriptive, cross-sectional prospective design, the study surveyed resident physicians working at a tertiary government hospital from January 2021 to March 2023. Data collection utilized self-administered questionnaires, incorporating structured and open-ended questions. Data were subjected to descriptive analysis, with frequencies, percentages, and means presented. The Kruskall-Wallis test, chi-square test and Correlation Phi Coefficient were employed for statistical comparisons. This pioneering exploration among 97 resident physicians underscores their strong recognition of fundamental nutritional aspects. Knowledge levels varied from moderate (61.9%) to excellent (32.9%), with a minority having poor knowledge (5.2%). A significant relationship between years of residency and knowledge (p value= 0.01 Kruskall Walis, 0.029 Chi square), along with a strong relationship correlation was observed. The connection between attitude and practice to years of residency was less pronounced. Findings reveal knowledge gaps and potential disparities between attitudes and practices across different year levels, offering insights for tailored educational interventions and future research. The study underscores the imperative for targeted interventions to strengthen nutrition education among resident physicians. It signifies bolstering nutrition education to advance better patient care.

OBJECTIVE: To determine the reliability and validity of the modified pediatric nutrition screening tool in identifying malnutrition and risk of malnutrition among admitted pediatric patients aged 6 to 18 years old. METHOD: The Modified Pediatric Nutritional Screening Tool (PNST) was used to assess 130 admitted patients aged 6 to 18 years old. Evaluation of anthropometric measurements, body weight changes, clinical conditions and dietary intake were done within 48 hours of admission. Intraclass correlation coefficient was used to determine reliability of the tool among different raters while chi square test was used to determine correlation of the tool with the Screening Tool for the Assessment for Malnutrition in Pediatrics (STAMP). RESULT: The comparison of the modified PNST measurements by two observers showed no significant difference with p value of 0.078. All PNST criteria except clinical condition were associated with risk of malnutrition based on STAMP. The overall modified PNST criteria is significantly associated with risk of malnutrition based on STAMP. CONCLUSION The modified PNST accurately identifies malnutrition and risk of malnutrition among admitted patients aged 6-18 years old. The criteria used in the modified PNST were strongly associated with risk for malnutrition measured using previously validated tools and demonstrates a good interobserver reliability. It is recommended to be used as routine screening in the hospital set- ting for early identification of malnutrition and risk for malnutrition.
Malnutrition ; Pediatrics

Objective: To compare the application of China growth standard for children under 7 years of age (China standards) and World Health Organization child growth standards (WHO standards) in evaluating the prevalence of malnutrition in children aged 0-<6 years in China. Methods: The research data came from the national special program for science & technology basic resources investigation of China, named "2019-2021 survey and application of China's nutrition and health system for children aged 0-18 years". Multi-stage stratified random sampling was used to recruit 28 districts (regions) in 14 provinces, autonomous regions or municipalities across the country. Children (n=38 848) were physically measured and questionnaires were conducted in the guardians of the children. The indicators of stunting, underweight, wasting, overweight and obesity were evaluated by China standards and WHO standards respectively. Chi-square test was used to comparing the prevalence of each nutritional status between the two standards, as well as the comparison between the two standards by gender and age. Results: Among the 38 848 children, 19 650 were boys (50.6%) and 19 198 were girls (49.4%), 19 480 urban children (50.1%) and 19 368 rural children (49.9%). The stunting, underweight and wasting cases in the study population were 2 090 children (5.4%), 1 354 children (3.5%) and 1 276 children (3.3%) according to the China standards, and 1 474 children (3.8%), 701 children (1.8%) and 824 children (2.1%) according to the WHO standards, respectively; the above rates according to the China standards were slightly higher than those to the WHO standards (χ²=111.59, 213.14, and 99.99, all P<0.001). The overweight and obesity cases in the study population were 2 186 children (5.6%) and 1 153 children (3.0%) according to the China standards, and 2 210 children (5.7%) and 1 186 children (3.1%) according to the WHO standards, with no statistically significant differences (χ²=0.14 and 0.48, P=0.709 and 0.488, respectively). Compared to the results based on WHO standards, the China standards showed a lower prevalence of overweight and obesity in boys (χ²=14.95 and 5.85, P<0.001 and =0.016, respectively), and higher prevalence of overweight in girls (χ²=12.60, P<0.001); but there was no statistically significant differences in girls' obesity prevalence between the two standards (χ²=2.62, P=0.106). Conclusions: In general, the prevalence of malnutrition among children aged 0-<6 years based on China standards is slightly higher than that on WHO standards. To evaluate the nutritional status of children, it is advisable to select appropriate child growth standards based on work requirements, norms or research objectives.
Male ; Female ; Child ; Humans ; Child, Preschool ; Nutritional Status ; Overweight/epidemiology* ; Thinness/epidemiology* ; Obesity/epidemiology* ; Malnutrition/epidemiology* ; Growth Disorders/epidemiology* ; China/epidemiology* ; Prevalence

Objective: To analyze the clinical characteristics and risk factors of protein energy wasting (PEW) in children with chronic kidney disease (CKD). Methods: Clinical data of 231 children with chronic kidney disease hospitalized in Beijing Children's Hospital affiliated to Capital Medical University from January 2018 to January 2023 were retrospectively analyzed to explore the incidence of PEW. According to the diagnostic criteria of CKDPEW, they were divided into a CKDPEW group and a non PEW group. The comparison between the groups was performed by independent-sample t test and Chi-squared test, and the risk factors were analyzed by multivariate Logistic regression. Results: Among the 231 children, there were 138 males and 93 females, with a visiting age of 9.9 (7.9, 16.0) years; 6 cases were in stage 1, 14 cases in stage 2, 51 cases in stage 3, 36 cases in stage 4, and 124 cases in stage 5. A total of 30 children (13.0%) with CKD PEW were diagnosed at the age of 7. 1 (3.8, 13.2) years, including 1 case in stage 1, 1 case in stage 2, 5 cases in stage 3, 5 cases in stage 4, and 18 cases in stage 5. There were a total of 201 cases (87.0%) in the non PEW group, diagnosed at the age of 11.8 (8.5, 12.2) years, including 5 cases in stage 1, 13 cases in stage 2, 46 cases in stage 3, 31 cases in stage 4, and 106 cases in stage 5. The Chi-squared test and t test showed that the systolic blood pressure, diastolic blood pressure, birth weight and carbon dioxide binding capacity of the CKD PEW group were lower than those of the non PEW group ((109±22) vs. (120±20) mmHg (1 mmHg=0.133 kPa), (72±19) vs. (79±16) mmHg, (2.9±0.5) vs. (3.2±0.6) kg, (17±4) vs. (19±4) mmol/L,t=2.85, 2.14, 0.67, 2.63, all P<0.05). Multivariate logistic regression analysis showed that carbon dioxide binding capacity and birth weight were independent protective factors of CKDPEW in children (OR=0.81 and 0.36, 95%CI=0.73-0.90 and 0.17-0.77, respectively; both P<0.01); the risk of PEW in CKD children decreased by 0.187 times for every 1 mmol/L increment in carbon dioxide binding capacity, and 0.638 times for every 1 kg increment in birth weight. Conclusions: The incidence of protein energy expenditure in children with chronic kidney disease is lower than that in the previous researches. PEW can appear in CKD 1-2 stage, and attention should be paid to it in the early stage of CKD in clinical practice. Low birth weight CKD children are susceptible to PEW, and actively correcting metabolic acidosis can reduce the risk of CKDPEW.
Renal Insufficiency, Chronic/epidemiology* ; Humans ; Child ; Energy Metabolism ; Protein-Energy Malnutrition/epidemiology* ; Risk Factors ; Adolescent ; Male ; Female ; Proteins/metabolism* ; China/epidemiology*